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  • C07D213/00—Heterocyclic compounds containing six-membered rings, not condensed with other rings, with one nitrogen atom as the only ring hetero atom and three or more double bonds between ring members or between ring members and non-ring members
  • C07D213/02—Heterocyclic compounds containing six-membered rings, not condensed with other rings, with one nitrogen atom as the only ring hetero atom and three or more double bonds between ring members or between ring members and non-ring members having three double bonds between ring members or between ring members and non-ring members
  • C07D213/04—Heterocyclic compounds containing six-membered rings, not condensed with other rings, with one nitrogen atom as the only ring hetero atom and three or more double bonds between ring members or between ring members and non-ring members having three double bonds between ring members or between ring members and non-ring members having no bond between the ring nitrogen atom and a non-ring member or having only hydrogen or carbon atoms directly attached to the ring nitrogen atom
  • C07D213/24—Heterocyclic compounds containing six-membered rings, not condensed with other rings, with one nitrogen atom as the only ring hetero atom and three or more double bonds between ring members or between ring members and non-ring members having three double bonds between ring members or between ring members and non-ring members having no bond between the ring nitrogen atom and a non-ring member or having only hydrogen or carbon atoms directly attached to the ring nitrogen atom with substituted hydrocarbon radicals attached to ring carbon atoms
  • C07D213/28—Radicals substituted by singly-bound oxygen or sulphur atoms
  • C07D213/30—Oxygen atoms
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  • C07D401/00—Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom
  • C07D401/02—Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom containing two hetero rings
  • C07D401/04—Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom containing two hetero rings directly linked by a ring-member-to-ring-member bond
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
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  • A61P25/00—Drugs for disorders of the nervous system
  • A61P25/04—Centrally acting analgesics, e.g. opioids
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  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
  • A61P25/14—Drugs for disorders of the nervous system for treating abnormal movements, e.g. chorea, dyskinesia
  • A61P25/16—Anti-Parkinson drugs
• • A—HUMAN NECESSITIES
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  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
  • A61P25/24—Antidepressants
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
  • A61P25/28—Drugs for disorders of the nervous system for treating neurodegenerative disorders of the central nervous system, e.g. nootropic agents, cognition enhancers, drugs for treating Alzheimer's disease or other forms of dementia
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P29/00—Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID]
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P3/00—Drugs for disorders of the metabolism
  • A61P3/04—Anorexiants; Antiobesity agents
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• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07D—HETEROCYCLIC COMPOUNDS
  • C07D213/00—Heterocyclic compounds containing six-membered rings, not condensed with other rings, with one nitrogen atom as the only ring hetero atom and three or more double bonds between ring members or between ring members and non-ring members
  • C07D213/02—Heterocyclic compounds containing six-membered rings, not condensed with other rings, with one nitrogen atom as the only ring hetero atom and three or more double bonds between ring members or between ring members and non-ring members having three double bonds between ring members or between ring members and non-ring members
  • C07D213/04—Heterocyclic compounds containing six-membered rings, not condensed with other rings, with one nitrogen atom as the only ring hetero atom and three or more double bonds between ring members or between ring members and non-ring members having three double bonds between ring members or between ring members and non-ring members having no bond between the ring nitrogen atom and a non-ring member or having only hydrogen or carbon atoms directly attached to the ring nitrogen atom
  • C07D213/60—Heterocyclic compounds containing six-membered rings, not condensed with other rings, with one nitrogen atom as the only ring hetero atom and three or more double bonds between ring members or between ring members and non-ring members having three double bonds between ring members or between ring members and non-ring members having no bond between the ring nitrogen atom and a non-ring member or having only hydrogen or carbon atoms directly attached to the ring nitrogen atom with hetero atoms or with carbon atoms having three bonds to hetero atoms with at the most one bond to halogen, e.g. ester or nitrile radicals, directly attached to ring carbon atoms
  • C07D213/61—Halogen atoms or nitro radicals
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07D—HETEROCYCLIC COMPOUNDS
  • C07D213/00—Heterocyclic compounds containing six-membered rings, not condensed with other rings, with one nitrogen atom as the only ring hetero atom and three or more double bonds between ring members or between ring members and non-ring members
  • C07D213/02—Heterocyclic compounds containing six-membered rings, not condensed with other rings, with one nitrogen atom as the only ring hetero atom and three or more double bonds between ring members or between ring members and non-ring members having three double bonds between ring members or between ring members and non-ring members
  • C07D213/04—Heterocyclic compounds containing six-membered rings, not condensed with other rings, with one nitrogen atom as the only ring hetero atom and three or more double bonds between ring members or between ring members and non-ring members having three double bonds between ring members or between ring members and non-ring members having no bond between the ring nitrogen atom and a non-ring member or having only hydrogen or carbon atoms directly attached to the ring nitrogen atom
  • C07D213/60—Heterocyclic compounds containing six-membered rings, not condensed with other rings, with one nitrogen atom as the only ring hetero atom and three or more double bonds between ring members or between ring members and non-ring members having three double bonds between ring members or between ring members and non-ring members having no bond between the ring nitrogen atom and a non-ring member or having only hydrogen or carbon atoms directly attached to the ring nitrogen atom with hetero atoms or with carbon atoms having three bonds to hetero atoms with at the most one bond to halogen, e.g. ester or nitrile radicals, directly attached to ring carbon atoms
  • C07D213/72—Nitrogen atoms
  • C07D213/74—Amino or imino radicals substituted by hydrocarbon or substituted hydrocarbon radicals
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  • C07—ORGANIC CHEMISTRY
  • C07D—HETEROCYCLIC COMPOUNDS
  • C07D307/00—Heterocyclic compounds containing five-membered rings having one oxygen atom as the only ring hetero atom
  • C07D307/02—Heterocyclic compounds containing five-membered rings having one oxygen atom as the only ring hetero atom not condensed with other rings
  • C07D307/34—Heterocyclic compounds containing five-membered rings having one oxygen atom as the only ring hetero atom not condensed with other rings having two or three double bonds between ring members or between ring members and non-ring members
  • C07D307/38—Heterocyclic compounds containing five-membered rings having one oxygen atom as the only ring hetero atom not condensed with other rings having two or three double bonds between ring members or between ring members and non-ring members with substituted hydrocarbon radicals attached to ring carbon atoms
  • C07D307/40—Radicals substituted by oxygen atoms
  • C07D307/42—Singly bound oxygen atoms
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07D—HETEROCYCLIC COMPOUNDS
  • C07D307/00—Heterocyclic compounds containing five-membered rings having one oxygen atom as the only ring hetero atom
  • C07D307/02—Heterocyclic compounds containing five-membered rings having one oxygen atom as the only ring hetero atom not condensed with other rings
  • C07D307/34—Heterocyclic compounds containing five-membered rings having one oxygen atom as the only ring hetero atom not condensed with other rings having two or three double bonds between ring members or between ring members and non-ring members
  • C07D307/56—Heterocyclic compounds containing five-membered rings having one oxygen atom as the only ring hetero atom not condensed with other rings having two or three double bonds between ring members or between ring members and non-ring members with hetero atoms or with carbon atoms having three bonds to hetero atoms with at the most one bond to halogen, e.g. ester or nitrile radicals, directly attached to ring carbon atoms
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07D—HETEROCYCLIC COMPOUNDS
  • C07D333/00—Heterocyclic compounds containing five-membered rings having one sulfur atom as the only ring hetero atom
  • C07D333/02—Heterocyclic compounds containing five-membered rings having one sulfur atom as the only ring hetero atom not condensed with other rings
  • C07D333/04—Heterocyclic compounds containing five-membered rings having one sulfur atom as the only ring hetero atom not condensed with other rings not substituted on the ring sulphur atom
  • C07D333/06—Heterocyclic compounds containing five-membered rings having one sulfur atom as the only ring hetero atom not condensed with other rings not substituted on the ring sulphur atom with only hydrogen atoms, hydrocarbon or substituted hydrocarbon radicals, directly attached to the ring carbon atoms
  • C07D333/14—Radicals substituted by singly bound hetero atoms other than halogen
  • C07D333/16—Radicals substituted by singly bound hetero atoms other than halogen by oxygen atoms
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07D—HETEROCYCLIC COMPOUNDS
  • C07D405/00—Heterocyclic compounds containing both one or more hetero rings having oxygen atoms as the only ring hetero atoms, and one or more rings having nitrogen as the only ring hetero atom
  • C07D405/02—Heterocyclic compounds containing both one or more hetero rings having oxygen atoms as the only ring hetero atoms, and one or more rings having nitrogen as the only ring hetero atom containing two hetero rings
  • C07D405/04—Heterocyclic compounds containing both one or more hetero rings having oxygen atoms as the only ring hetero atoms, and one or more rings having nitrogen as the only ring hetero atom containing two hetero rings directly linked by a ring-member-to-ring-member bond
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07D—HETEROCYCLIC COMPOUNDS
  • C07D409/00—Heterocyclic compounds containing two or more hetero rings, at least one ring having sulfur atoms as the only ring hetero atoms
  • C07D409/02—Heterocyclic compounds containing two or more hetero rings, at least one ring having sulfur atoms as the only ring hetero atoms containing two hetero rings
  • C07D409/04—Heterocyclic compounds containing two or more hetero rings, at least one ring having sulfur atoms as the only ring hetero atoms containing two hetero rings directly linked by a ring-member-to-ring-member bond

Definitions

• the present invention relates to l-(2-phenoxymethylheteroaryl)piperidine and l-(2- phenoxymethylheteroaryl)piperazine compounds having activity as serotonin (5-HT) and norepinephrine (NE) reuptake inhibitors.
• the invention also relates to pharmaceutical compositions comprising such compounds, processes and intermediates for preparing such compounds and methods of using such compounds to treat a pain disorder, such as neuropathic pain, and other ailments.
• Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage (International Association for the Study of Pain (IASP), Pain Terminology). Chronic pain persists beyond acute pain or beyond the expected time for an injury to heal (American Pain Society. "Pain Control in the Primary Care Setting.” 2006: 15).
• Neuropathic pain is pain initiated or caused by a primary lesion or dysfunction in the nervous system. Peripheral neuropathic pain occurs when the lesion or dysfunction affects the peripheral nervous system and central neuropathic pain when the lesion or dysfunction affects the central nervous system (IASP).
• neuropathic pain can be very difficult to treat with no more than 40-60% of patients achieving, at best, partial relief of their pain (Dworkin et al. (2007) Pain 132:237-251).
• all of the therapeutic agents currently used to treat neuropathic pain have various side effects (e.g., nausea, sedation, dizziness and somnolence) that can limit their effectiveness in some patients (Dworkin et al. supra).
• SNRIs such as duloxetine and venlafaxine
• SNRIs are often used as first line therapy for treating neuropathic pain. These agents inhibit the reuptake of both serotonin (5- Attorney Docket No. P-268-PCT
• the present invention provides novel compounds that have been found to possess serotonin reuptake inhibitory activity and norepinephrine reuptake inhibitory activity. Accordingly, compounds of the invention are expected to be useful and advantageous as therapeutic agents for those diseases and disorders that can be treated by inhibition of the serotonin and/or norepinephrine transporter, such as neuropathic pain.
• One aspect of the invention relates to compounds of formula I:
• X is -CH- or -N-;
• HAr is Cs-sheteroaryl;
• a is 0 or 1 ;
• R 1 is halo or trifluoromethyl;
• R 2 6 are independently hydrogen, halo, -CF 3 , -C2- 6 alkynyl, -0-Ci_ 6 alkyl, -OCF 3 , -Ci-4alkylene-0-Ci_4alkyl, -Co-ialkylene-phenyl, -0-Co- 3 alkylene-phenyl,
• compositions comprising a pharmaceutically acceptable carrier and a compound of the invention.
• Such compositions may optionally contain other active agents such as anti-Alzheimer's agents, anticonvulsants, antidepressants, anti-Parkinson's agents, dual serotonin-norepinephrine reuptake inhibitors, non-steroidal anti-inflammatory agents, norepinephrine reuptake inhibitors, opioid agonists, opioid antagonists, selective serotonin reuptake inhibitors, sodium channel blockers, sympatholytics, and combinations thereof.
• a pharmaceutical composition comprises a compound of the invention, a second active agent, and a pharmaceutically acceptable carrier.
• Another aspect of the invention relates to a combination of active agents, comprising a compound of the invention and a second active agent.
• the compounds of the invention can be formulated together or separately from the additional agent(s).
• a pharmaceutically acceptable carrier may be included with the additional agent(s).
• yet another aspect of the invention relates to a combination of pharmaceutical compositions, the combination comprising: a first pharmaceutical composition comprising a compound of formula I or a pharmaceutically acceptable salt thereof and a first pharmaceutically acceptable carrier; and a second pharmaceutical composition comprising a second active agent and a second pharmaceutically acceptable carrier.
• the invention also relates to a kit containing such pharmaceutical compositions, for example where the first and second pharmaceutical compositions are separate pharmaceutical compositions.
• one aspect of the invention relates to a method of treating: a pain disorder such as neuropathic pain or fibromyalgia; a depressive disorder such as major depression; an affective disorder such as an anxiety disorder; attention deficit hyperactivity disorder; a cognitive disorder such as Attorney Docket No. P-268-PCT
• dementia dementia; stress urinary incontinence; chronic fatigue syndrome; obesity; or vasomotor symptoms associated with menopause, comprising administering to a patient a
• Still another aspect of the invention relates to a method for inhibiting serotonin reuptake in a mammal comprising administering to the mammal, a serotonin transporter- inhibiting amount of a compound of the invention.
• Yet another aspect of the invention relates to a method for inhibiting norepinephrine reuptake in a mammal comprising administering to the mammal, a norepinephrine transporter-inhibiting amount of a compound of the invention.
• Another aspect of the invention is directed to a method for inhibiting serotonin reuptake and norepinephrine reuptake in a mammal comprising administering to the mammal, a serotonin transporter- and norepinephrine transporter- inhibiting amount of a compound of the invention.
• compounds of particular interest are those having an inhibitory constant ( ⁇ 3 ⁇ 4) at SERT and at NET greater than or equal to about 5.0; and in another embodiment having a p3 ⁇ 4 at SERT and at NET greater than or equal to about 7.0.
• compounds of interest have balanced SERT and NET activity, i.e., have the same p3 ⁇ 4 value at both SERT and NET ⁇ 0.5.
• compounds of particular interest are those having serotonin reuptake inhibition pICso values of greater than or equal to about 7.0 and norepinephrine reuptake inhibition pICso values of greater than or equal to about 7.0.
• one aspect of the invention relates to methods of using the compounds of the invention as research tools, comprising conducting a biological assay using a compound of the invention.
• Compounds of the invention can also be used to evaluate new chemical compounds.
• another aspect of the invention relates to a method of evaluating a test compound in a biological assay, comprising: (a) conducting a biological assay with a test compound to provide a first assay value; (b) conducting the biological assay with a compound of the invention to provide a second assay value;
• step (a) is conducted either before, after or concurrently with step (b); and (c) comparing the first assay value from step (a) with the second assay value from step (b).
• exemplary biological assays include a serotonin reuptake assay and a norepinephrine reuptake assay.
• Still another aspect of the invention relates to a method of studying a Attorney Docket No. P-268-PCT
• the method comprising: (a) contacting the biological system or sample with a compound of the invention; and (b) determining the effects caused by the compound on the biological system or sample.
• the invention also relates to processes and intermediates useful for preparing compounds of the invention. Accordingly, one aspect of the invention relates to a process for preparing compounds of formula I, the process comprising deprotecting a compound of formula IV:
• Yet another aspect of the invention relates to compounds of the invention for use in therapy, the use of compounds of the invention for the manufacture of medicaments, especially for the manufacture of medicaments useful for treating pain disorders, depressive disorders, affective disorders, attention deficit hyperactivity disorder, cognitive disorders, stress urinary incontinence, for inhibiting serotonin reuptake in a mammal, or for inhibiting norepinephrine reuptake in a mammal.
• Still another aspect of the invention relates to the use of compounds of the invention as research tools. Other aspects and embodiments of the invention are disclosed herein.
• alkyl means a monovalent saturated hydrocarbon group which may be linear or branched. Unless otherwise defined, such alkyl groups typically contain from 1 to 10 carbon atoms and include, for example, -C 1-2 alkyl, -Ci_ 3 alkyl, -Ci-4alkyl, -Ci_ 6 alkyl, and -Ci-salkyl.
• alkyl groups include, by way of example, methyl, ethyl, n- propyl, isopropyl, w-butyl, sec-butyl, isobutyl, tert-butyl, w-pentyl, w-hexyl, w-heptyl, n- octyl, M-nonyl, w-decyl, and the like.
• the number of carbon atoms is shown preceding the term as subscript.
• the term "-Ci_ 6 alkyl” means an alkyl group having from 1 to 6 carbon atoms
• the term “-Ci-4alkylene” means an alkylene group having from 1 to 4 carbon atoms, where the carbon atoms are in any acceptable configuration.
• alkylene means a divalent saturated hydrocarbon group that may be linear or branched. Unless otherwise defined, such alkylene groups typically contain from 0 to 10 carbon atoms and include, for example, -Co-i alkylene, -Co-2alkylene, -C0-3 alkylene, -Co- 6 alkylene, -Ci-4alkylene, -C2- 4 alkylene and -Ci- 6 alkylene.
• alkylene groups include, by way of example, methylene (-CH 2 -), ethylene (-CH 2 -CH 2 -), propylene (-CH 2 -CH 2 -CH 2 -, -CH 2 (CH 3 )-CH 2 -, or -CH 2 -CH 2 (CH 3 )-), butylene (-CH 2 -CH 2 -CH 2 -CH 2 -, -CH 2 (CH 3 )-CH 2 -CH 2 -, -CH 2 -CH 2 (CH 3 )-CH 2 -, -CH 2 -CH 2 -CH 2 (CH 3 )-, -CH 2 -CH 2 -CH 2 (CH 3 )-,
• alkylene term includes zero carbons such as -Co-i alkylene-, -Co- 3 alkylene- or -Co-6alkylene-, such terms are intended to include the absence of carbon atoms, i.e., the alkylene group is not present except for a covalent bond attaching the groups separated by the alkylene term.
• alkynyl means a monovalent unsaturated hydrocarbon group which may be linear or branched and which has at least one, and typically 1, 2 or 3, carbon-carbon Attorney Docket No. P-268-PCT
• alkynyl groups typically contain from 2 to 10 carbon atoms and include, for example, -C2- 4 alkynyl, -C2- 6 alkynyl and -C3_ioalkynyl.
• alkynyl groups include, by way of example, ethynyl, w-propynyl, z ' -butynyl, M-but-2-ynyl, w-hex-3-ynyl, and the like.
• halo means fluoro, chloro, bromo and iodo.
• Cs-sheteroaryl means a monovalent aromatic group having a single ring and containing in the ring one or two heteroatoms selected from nitrogen, oxygen, and sulfur. Unless otherwise defined, such heteroaryl groups typically contain from 5 to 7 total ring atoms. Typically, the point of attachment is at any available carbon atom.
• Csheteroaryl groups include, oxazole (e.g., 2-oxazole and 5-oxazole), isoxazole (e.g., 3-isoxazole), thiazole (e.g., 2-thiazole and 4-thiazole), isothiazole (e.g., 3- isothiazole), imidazole (e.g., 2-imidazole), and pyrazole (e.g., lH-pyrazol-3-yl).
• oxazole e.g., 2-oxazole and 5-oxazole
• isoxazole e.g., 3-isoxazole
• thiazole e.g., 2-thiazole and 4-thiazole
• isothiazole e.g., 3- isothiazole
• imidazole e.g., 2-imidazole
• pyrazole e.g., lH-pyrazol-3-yl
• Representative C 4 heteroaryl groups include, thiophene (e.g., 2-thienyl), furan (e.g., 2-furyl and 3-furyl), pyrrole (e.g., 3- pyrrolyl and 2H-pyrrol-3-yl), pyrazine, pyrimidine (e.g., 2,6- pyrimidinyl and 3,5-pyrimidinyl), and pyridazine (e.g., 3-pyridazinyl).
• Representative C 5 heteroaryl groups include pyridine (e.g., 2-pyridyl, 3-pyridyl, and 4-pyridyl) and pyran (e.g., 2H-pyran and 4H-pyran).
• pharmaceutically acceptable refers to a material that is not biologically or otherwise unacceptable when used in the invention.
• pharmaceutically acceptable refers to a material that is not biologically or otherwise unacceptable when used in the invention.
• pharmaceutically acceptable carrier refers to a material that can be incorporated into a composition and administered to a patient without causing unacceptable biological effects or interacting in an unacceptable manner with other components of the composition.
• Such pharmaceutically acceptable materials typically have met the required standards of toxicological and manufacturing testing, and include those materials identified as suitable inactive ingredients by the U.S. Food and Drug Administration.
• pharmaceutically acceptable salt means a salt prepared from a base or an acid which is acceptable for administration to a patient, such as a mammal (e.g., salts having acceptable mammalian safety for a given dosage regime).
• a mammal e.g., salts having acceptable mammalian safety for a given dosage regime.
• the salts covered by the invention are not required to be pharmaceutically acceptable salts, such as salts of intermediate compounds that are not intended for Attorney Docket No. P-268-PCT
• salts can be derived from pharmaceutically acceptable inorganic or organic bases and from pharmaceutically acceptable inorganic or organic acids.
• a compound of formula I contains both a basic moiety, such as an amine, and an acidic moiety such as a carboxylic acid, zwitterions may be formed and are included within the term "salt” as used herein.
• Salts derived from pharmaceutically acceptable inorganic bases include ammonium, calcium, copper, ferric, ferrous, lithium, magnesium, manganic, manganous, potassium, sodium, and zinc salts, and the like.
• Salts derived from pharmaceutically acceptable organic bases include salts of primary, secondary and tertiary amines, including substituted amines, cyclic amines, naturally-occurring amines, and the like, such as arginine, betaine, caffeine, choline, N,N-dibenzylethylenediamine, diethylamine, 2-diethylaminoethanol, 2- dimethylaminoethanol, ethanolamine, ethylenediamine, N-ethylmorpholine, N- ethylpiperidine, glucamine, glucosamine, histidine, hydrabamine, isopropylamine, lysine, methylglucamine, morpholine, piperazine, piperadine, polyamine resins, procaine, purines, theobromine, triethylamine, trimethylamine, tripropylamine, tromethamine, and the like.
• arginine betaine
• caffeine choline
• Salts derived from pharmaceutically acceptable inorganic acids include salts of boric, carbonic, hydrohalic (hydrobromic, hydrochloric, hydrofluoric or hydroiodic), nitric, phosphoric, sulfamic and sulfuric acids.
• Salts derived from pharmaceutically acceptable organic acids include salts of aliphatic hydroxyl acids (e.g., citric, gluconic, glycolic, lactic, lactobionic, malic, and tartaric acids), aliphatic monocarboxylic acids (e.g., acetic, butyric, formic, propionic and trifluoroacetic acids), amino acids (e.g., aspartic and glutamic acids), aromatic carboxylic acids (e.g., benzoic, p-chlorobenzoic, diphenylacetic, gentisic, hippuric, and triphenylacetic acids), aromatic hydroxyl acids (e.g., o-hydroxybenzoic, p- hydroxybenzoic, 1 -hydroxynaphthalene-2 -carboxylic and 3-hydroxynaphthalene-2- carboxylic acids), ascorbic, dicarboxylic acids (e.g., fumaric, maleic, oxalic and succinic acids),
• solvate means a complex or aggregate formed by one or more molecules of a solute, e.g., a compound of formula I or a pharmaceutically acceptable salt thereof, and one or more molecules of a solvent. Such solvates are typically crystalline solids having a substantially fixed molar ratio of solute and solvent.
• solvents include, by way of example, water, methanol, ethanol, isopropanol, acetic acid, and the like.
• the solvent is water, the solvate formed is a hydrate.
• terapéuticaally effective amount means an amount sufficient to effect treatment when administered to a patient in need thereof, i.e., the amount of drug needed to obtain the desired therapeutic effect.
• a therapeutically effective amount for treating neuropathic pain is an amount of compound needed to, for example, reduce, suppress, eliminate or prevent the symptoms of neuropathic pain or to treat the underlying cause of neuropathic pain.
• the term “effective amount” means an amount sufficient to obtain a desired result, which may not necessary be a therapeutic result. For example, when studying a system comprising a norepinephrine transporter, an "effective amount" may be the amount needed to inhibit norepinephrine reuptake.
• treating means the treating or treatment of a disease or medical condition (such as neuropathic pain) in a patient, such as a mammal (particularly a human), that includes one or more of the following: (a) preventing the disease or medical condition from occurring, i.e., prophylactic treatment of a patient; (b) ameliorating the disease or medical condition, i.e., eliminating or causing regression of the disease or medical condition in a patient; (c) suppressing the disease or medical condition, i.e., slowing or arresting the development of the disease or medical condition in a patient; or (d) alleviating the symptoms of the disease or medical condition in a patient.
• a disease or medical condition such as neuropathic pain
• a patient such as a mammal (particularly a human) that includes one or more of the following: (a) preventing the disease or medical condition from occurring, i.e., prophylactic treatment of a patient; (b) ameliorating the disease or medical condition, i.e., eliminating or
• treating neuropathic pain would include preventing neuropathic pain from occurring, ameliorating neuropathic pain, suppressing neuropathic pain, and alleviating the symptoms of neuropathic pain.
• patient is intended to include those mammals, such as humans, that are in need of treatment or disease prevention, that are presently being treated for disease prevention or treatment of a specific disease or medical condition, as well as test subjects in which compounds of the invention are being evaluated or being used in a assay, for example an animal model.
• this invention relates to compounds of formula I: Attorney Docket No. P-268-PCT
• the term "compound of the invention” or “compounds of the invention” include all compounds encompassed by formulas I, II, III, and IV, such as the species embodied in formulas la, lb, Ic, Id, Ie, If, Ig, Ih, and Ii, and all other subspecies of such formulas.
• a compound of the invention contain a basic or acidic group (e.g., amino or carboxyl groups)
• the compound can exist as a free base, free acid, a zwitterion, or in various salt forms. All such salt forms are included within the scope of the invention. Accordingly, those skilled in the art will recognize that reference to compounds herein, for example, reference to a "compound of the invention” or a
• compound of formula I includes a compound of formula I as well as pharmaceutically acceptable salts of that compound unless otherwise indicated. Furthermore, solvates are also included within the scope of this invention.
• Compounds of the invention may also include isotopically-labeled compounds, i.e., where one or more atoms have been enriched with atoms having an atomic mass different from the atomic mass predominately found in nature.
• isotopes that may be incorporated into the compounds of the invention, for example, include, but are not limited to, 2 H, 3 H, 13 C, 14 C, 15 N, 18 0, 17 0, 35 S, 36 C1, and 18 F.
• compounds of formula I enriched in tritium or carbon- 14 which can be used, for example, in tissue distribution studies; compounds of formula I enriched in deuterium especially at a site of metabolism resulting, for example, in compounds having greater metabolic stability; and compounds of formula I enriched in a
• positron emitting isotope such as C, F, O and N, which can be used, for example, in
• PET Positron Emission Topography
• the compounds of the invention have been found to possess serotonin reuptake inhibitory activity and norepinephrine reuptake inhibitory activity. Among other properties, such compounds are expected to be useful as therapeutic agents for treating chronic pain, such as neuropathic pain.
• dual activity into a single Attorney Docket No. P-268-PCT
• double therapy can be achieved, i.e., serotonin reuptake inhibitory activity and norepinephrine reuptake inhibitory activity, using a single active component. Since pharmaceutical compositions containing one active component are typically easier to formulate than compositions containing two active components, such single-component compositions provide a significant advantage over compositions containing two active components.
• SNRIs serotonin and norepinephrine reuptake inhibitors
• milnacipran, duloxetine, and venlafaxine exhibit 2.5-fold, 10-fold, and 100-fold selectivity (measured as p3 ⁇ 4 ) for SERT over NET, respectively.
• this invention relates to compounds of formula I:
• the R 2 , R 3 , R 4 , R 5 , and R 6 groups are independently hydrogen, halo, -Ci_ 6 alkyl, -CF 3 , -C2- 6 alkynyl, -0-Ci- 6 alkyl, -OCF 3 , -Ci-4alkylene-0-Ci-4alkyl, -Co-ialkylene-phenyl, -O-C 0 - 3 alkylene-phenyl, -C 0 - 6 alkylene-OH, -CN, -COOH, -CHO, -C(0)-Ci_ 6 alkyl, -C(0)0-Ci_ 4 alkyl, -CH 2 SH, -S-Ci_ 6 alkyl, -Ci_ 4 alkylene-S-Ci_ 4 alkyl, or -N0 2 .
• Each R group is independently hydrogen or -Ci_ 4 alkyl.
• one or more positions on the phenyl ring are substituted with a non-hydrogen moiety.
• R 2 is a non-hydrogen moiety. It is understood that this means that R 2 can be any of the non-hydrogen moieties defined in formula I, i.e., halo, -Ci_ 6 alkyl, -CF 3 , -C 2 - 6 alkynyl, -0-Ci_ 6 alkyl, -OCF 3 , -Ci_ 4 alkylene-0-Ci_ 4 alkyl,
• Exemplary halo groups include fluoro, chloro, bromo, and iodo.
• -Ci- 6 alkyl groups include -CH 3 , -CH 2 CH 3 , and -CH(CH 3 ) 2 .
• Exemplary -0-Ci- 6 alkyl groups include -OCH 3 , -0-CH 2 CH 3 , and -OCH(CH 3 ) 2 .
• Exemplary -Ci- 4 alkylene-0-Ci- 4 alkyl groups include -CH 2 -OCH 3 and -CH 2 - OCH 2 CH 3 .
• Exemplary -Co-ialkylene-phenyl groups include phenyl and benzyl.
• Exemplary -0-Co- 3 alkylene-phenyl groups include -O-phenyl and -O-benzyl.
• Exemplary -Co- 6 alkylene-OH groups include -OH and -CH 2 OH.
• Exemplary -C(0)-Ci_ 6 alkyl groups include -C(0)CH 3 and -C(0)CH 2 CH 3 .
• Exemplary -C(0)0-Ci- 4 alkyl groups include -C(0)OCH 3 , -C(0)OCH 2 CH 3 , and -C(0)OCH(CH 3 ) 2 .
• Exemplary -S-Ci_ 6 alkyl groups include -SCH 3 .
• Exemplary -Ci-4alkylene-S-Ci-4alkyl groups include -CH 2 -S-CH 3 .
• R 2 is hydrogen or halo (e.g., fluoro or chloro).
• R 3 is hydrogen or halo (e.g., fluoro or chloro).
• R 4 is hydrogen or halo (e.g., fluoro or chloro).
• R 5 is hydrogen or halo (e.g., fluoro).
• R 6 is hydrogen or halo (e.g., fluoro or chloro).
• the "X” group is -CH- or -N-. In one particular embodiment, the "X" group is
• the "HAr” ring is a C 3 _5heteroaryl group. In one embodiment of the invention, the
• HARM ring is a pyridine, such as 2-pyridyl, 3-pyridyl, 4-pyridyl, or 5-pyridyl, which can be Attorney Docket No. P-268-PCT
• the "HAr" ring is a furan, such as 2-furyl, 3-furyl, or 4-furyl, which can be depicted as formulas Ie-Ig, respectively:
• the "HAr" ring is a thiophene, such as 2-thienyl, 3-thienyl, or 4-thienyl, which can be depicted as formulas Ih-Ii, respectively: Attorney Docket No. P-268-PCT
• R 2 6 are independently hydrogen or halo.
• Exemplary combinations include:
• R 2 -R 6 are hydrogen
• R 2 is fluoro and R 3 -R 6 are hydrogen
• R 2 is hydrogen, R 3 is chloro, and R 4 -R 6 are hydrogen;
• R 2 is fluoro
• R 3 -R 5 are hydrogen
• R 6 is fluoro
• R 2 is fluoro, R 3 -R 5 are hydrogen, and R 6 is chloro;
• R 2 is chloro, R 3 -R 5 are hydrogen, and R 6 is chloro;
• R 2 is chloro, R 3 -R 5 are hydrogen, and R 6 is fluoro;
• R 2 and R 3 are fluoro, R 4 and R 5 are hydrogen, and R 6 is fluoro;
• R 2 is fluoro
• R 3 is hydrogen
• R 4 is fluoro
• R 5 is hydrogen
• R 6 is fluoro
• R 2 is fluoro
• R 3 is hydrogen
• R 4 is chloro
• R 5 is hydrogen
• R 6 is fluoro
• R 2 is fluoro
• R 3 and R 4 are hydrogen
• R 5 is fluoro
• R 6 is chloro
• these embodiments have formulas (Ia)-(Ii).
• the compounds of the invention have formula II: Attorney Docket No. P-268-PCT
• X, HAr, a, R 1 , and R 3 through R 6 are as defined for formula I; or a pharmaceutically acceptable salt thereof.
• X is -CH-; a is 0; HAr is selected from 2-pyridyl, 3-pyridyl, 4-pyridyl, 5-pyridyl, 2-furyl, 4-furyl, 2-thienyl, 3- thienyl, and 4-thienyl; and R 3"6 are independently hydrogen or halo.
• the compounds of the invention have formula III:
• HAr and R 2 through R 6 are as defined for formula I; or a pharmaceutically acceptable salt thereof.
• HAr is selected from 2- pyridyl, 3-pyridyl, 4-pyridyl, 5-pyridyl, 2-furyl, 4-furyl, 2-thienyl, 3-thienyl, and 4-thienyl; and R 2 6 are independently hydrogen or halo; or a pharmaceutically acceptable salt thereof.
• protecting groups may be necessary or desired to prevent certain functional groups from undergoing undesired reactions.
• the choice of a suitable protecting group for a particular functional group as well as suitable conditions and reagents for protection and deprotection of such functional groups are well-known in the art.
• Protecting groups other than those illustrated in the procedures described herein may be used, if desired. For example, numerous protecting groups, and their introduction and removal, are described in T. W. Greene and G. M. Wuts, Protecting Groups in Organic Synthesis, Third Edition, Wiley, New York, 1999, and references cited therein.
• P represents an "amino-protecting group," a term used herein to mean a protecting group suitable for preventing undesired reactions at an amino group.
• Representative amino-protecting groups include, but are not limited to, t- butoxycarbonyl (Boc), trityl (Tr), benzyloxycarbonyl (Cbz), 9-fluorenylmethoxycarbonyl (Fmoc), formyl, benzyl, and the like.
• Standard deprotection techniques and reagents such as TFA in DCM or HC1 in 1 ,4-dioxane, methanol, or ethanol, are used to remove protecting groups, when present.
• a Boc group can be removed using an acidic reagent such as hydrochloric acid, trifluoroacetic acid, and the like; while a Cbz group can be removed by employing catalytic hydrogenation conditions such as H 2 (1 atm), 10% Pd/C in an alcoholic solvent.
• an acidic reagent such as hydrochloric acid, trifluoroacetic acid, and the like
• a Cbz group can be removed by employing catalytic hydrogenation conditions such as H 2 (1 atm), 10% Pd/C in an alcoholic solvent.
• the schemes are illustrated with Boc as the protecting group.
• Suitable inert diluents or solvents for use in these schemes include, by way of illustration and not limitation, tetrahydrofuran (THF), acetonitrile, N,N-dimethylformamide (DMF), dimethylsulfoxide (DMSO), toluene, dichloromethane (DCM), chloroform
• reactions may be complete in minutes, may take hours, typically from 1-2 hours and up to 48 hours, or days, such as up to 3-4 days.
• the resulting mixture or reaction product may be further treated in order to obtain the desired product.
• the resulting mixture or reaction product may be Attorney Docket No. P-268-PCT
• dilution for example with saturated aHCOs
• extraction for example, with ethyl acetate, CHCI 3 , DCM, aqueous HQ
• washing for example, with DCM, saturated aqueous NaCl, or saturated aqueous
• aHCOs drying (for example, over MgS0 4 or Na 2 S0 4 , or in vacuo); filtration; being concentrated (for example, in vacuo); being redissolved (for example in a 1 : 1 acetic acid:H 2 0 solution); and/or purification (for example by preparative HPLC, reverse phase preparative HPLC, or crystallization).
• azodicarboxylate DEAD
• a phosphine catalyst such as triphenylphosphine (PPI1 3 ).
• the method of Scheme B involves first converting the hydroxyl group into a leaving group.
• Representative leaving groups include chloro, bromo and iodo groups; sulfonic ester groups, such as mesylate, tosylate, brosylate, nosylate, and the like; and acyloxy groups, such as acetoxy, trifluoroacetoxy, and the like.
• the alcohol can undergo tosylation with an appropriate reagent such as -toluenesulfonyl chloride (TsCl) in a suitable base such as DABCO (l,4-diazabicyclo[2.2.2]octane or
• the method of Scheme C involves first coupling the starting material with the desired substituted phenyl (where X is -O-SO2-CF 3 (i.e., triflate) or iodide) under modified Ullmann reaction conditions.
• the modified Ullmann reaction is typically conducted in the presence of a copper(I) iodide/ 1, 10-phenanthroline catalyst and a base such as cesium carbonate, in an appropriate solvent such as toluene or DMF.
• the resulting product is then deprotected to yield a compound of the invention.
• This final step is conducted under standard deprotection conditions, which will vary depending upon the protecting group used. For example, removal of the BOC group can be done using trifluoroacetic acid and dichloromethane.
• the triflate compound is either commercially available, or is readily synthesized by techniques that are well known in the art.
• X carbon
• the starting material where X is nitrogen can be prepared, for example, by techniques described in Louerat et al. (2005) Tetrahedron 61(20):4761-4768, Romero et al. (1994) J. Med. Chem. 37(7):999-1014, and Tran et al. (2007) J. Med. Chem. 50(25):6356-6366.
• the phenol compound Attorney Docket No. P-268-PCT
• pharmaceutically acceptable salts of the compounds of formula I or II can be prepared by contacting the free acid or base form of a compound of formula I or II, respectively, with a pharmaceutically acceptable base or acid.
• compounds of the invention can be prepared by deprotecting compounds of formula IV to provide compounds of formula I, II, or III, or a pharmaceutically acceptable salt thereof.
• compounds of the invention possess serotonin and norepinephrine reuptake inhibitory activity. Thus, these compounds are expected to have therapeutic utility as combined serotonin and norepinephrine reuptake inhibitors (SNRIs).
• compounds of the invention possess equal or approximately equal serotonin reuptake Attorney Docket No. P-268-PCT
• the inhibition constant (3 ⁇ 4) of a compound is the concentration of ligand in a radioligand binding inhibition assay that would occupy 50% of the transporters if no radioligand were present.
• 3 ⁇ 4 values can be determined from radioligand binding studies with 3 H-nisoxetine (for the norepinephrine transporter, NET) and 3 H-citalopram (for the serotonin transporter, SERT), as described in Assay 1. These 3 ⁇ 4 values are derived from IC50 values in the binding assay using the Cheng-Prusoff equation and the Ka of the radioligand (Cheng & Prusoff (1973) Biochem. Pharmacol. 22(23):3099-3108).
• Functional IC 50 values can be determined in the functional inhibition of uptake assays described in Assay 2. These IC 50 values can be converted to 3 ⁇ 4 values using the Cheng- Prusoff equation and the K m of the transmitter for the transporter. It is noted however, that the uptake assay conditions described in Assay 2 are such that the IC 50 values are very close to the 3 ⁇ 4 values, should a mathematical conversion be desired, since the
• neurotransmitter concentration (5-HT or NE) used in the assay is well below its K m for the respective transporter.
• One measure of the affinity of a compound for SERT or NET is the inhibitory constant (p3 ⁇ 4) for binding to the transporter.
• the p3 ⁇ 4 value is the negative logarithm to base 10 of the 3 ⁇ 4.
• Compounds of the invention of particular interest are those having a p3 ⁇ 4 at SERT greater than or equal to about 5.0; and in another embodiment greater than or equal to about 7.0.
• Compounds of the invention of particular interest also include those having a p3 ⁇ 4 at NET greater than or equal to about 5.0; and in another embodiment greater than or equal to about 7.0.
• compounds of interest have a p3 ⁇ 4 at both SERT and NET greater than or equal to about 7.0.
• compounds of interest have balanced SERT and NET activity, i.e., have the same p3 ⁇ 4 value at both SERT and NET ⁇ 0.5.
• Such values can be determined by techniques that are well known in the art, as well as in the assays described herein.
• compounds of the invention exhibit a NET p3 ⁇ 4>7 and: a SERT Ki/NET 3 ⁇ 4 in the range of 0.1 to 100; a SERT K NET K ; in the range of 0.3 to 100; a SERT Ki/NET 3 ⁇ 4 in the range of 0.3 to 10; or a SERT K NET K ; in the range of 0.1 to 30.
• Another measure of serotonin and norepinephrine reuptake inhibition is the pICso value.
• compounds of interest have a serotonin reuptake inhibition PIC5 0 value of greater than or equal to about 7.0 and a norepinephrine reuptake inhibition PIC5 0 value of greater than or equal to about 7.0.
• the Attorney Docket No. P-268-PCT is another measure of serotonin and norepinephrine reuptake inhibition.
• the compounds have a serotonin reuptake inhibition pICso value of greater than or equal to about 7.0 and a norepinephrine reuptake inhibition pICso value of greater than or equal to about 7.0.
• the compounds of the invention have balanced PIC5 0 values, i.e., have the same pICso value at both SERT and NET ⁇ 0.5.
• compounds of the invention are selective for inhibition of
• compounds of particular interest are those that exhibit a binding affinity for SERT and NET that is at least 5 times higher than the binding affinity for DAT, or that is at least 10 times higher than for DAT, or at least 20 or 30 times higher than for DAT.
• the compounds do not exhibit significant DAT inhibition.
• the compounds exhibit less than 50% inhibition of DAT activity when measured at a concentration of 794 nM. Under the assay conditions used, a compound which exhibits ⁇ 50% inhibition would have an estimated p3 ⁇ 4 value at DAT of ⁇ 6.1.
• compounds of the invention possess dopamine reuptake inhibitory activity as well as SERT and NET activity.
• compounds of particular interest are those that exhibit a pK; at SERT and NET greater than or equal to about 7.0, and a pK; at DAT greater than or equal to about 7.0.
• compounds of the invention may possess either weak serotonin reuptake inhibitory activity or weak norepinephrine reuptake inhibitory activity.
• compounds of the invention may possess either weak serotonin reuptake inhibitory activity or weak norepinephrine reuptake inhibitory activity.
• those of ordinary skill in the art will recognize that such compounds still have utility as primarily either a NET inhibitor or a SERT inhibitor, respectively, or will have utility as research tools.
• Exemplary assays to determine the serotonin and/or norepinephrine reuptake inhibiting activity of compounds of the invention include by way of illustration and not limitation, assays that measure SERT and NET binding, for example, as described in Assay 1 and in Tsuruda et al. (2010) Journal of Pharmacological and Toxicological Methods 61(2): 192-204. In addition, it is useful to understand the level of DAT binding and uptake in an assay such as that described in Assay 1.
• Useful secondary assays include neurotransmitter uptake assays to measure inhibition of serotonin and norepinephrine uptake into cells expressing the respective human or rat recombinant transporter (hSERT, hNET, or hDAT) as described in Assay 2, and ex vivo radioligand binding and
• Other assays that are useful to evaluate pharmacological properties of test compounds include those listed in Assay 4.
• Exemplary in vivo assays include the formalin paw test described in Assay 5, which is a reliable predictor of clinical efficacy for the treatment of neuropathic pain, and the spinal nerve ligation model described in Assay 6.
• the aforementioned assays are useful in determining the therapeutic utility, for example, the neuropathic pain relieving activity, of compounds of the invention.
• Other properties and utilities of compounds of the invention can be demonstrated using various in vitro and in vivo assays well-known to those skilled in the art.
• Compounds of the invention are expected to be useful for the treatment and/or prevention of medical conditions in which the regulation of monoamine transporter function is implicated, in particular those conditions mediated by or responsive to the inhibition of serotonin and norepinephrine reuptake.
• patients suffering from a disease or disorder that is treated by the inhibition of the serotonin and/or the norepinephrine transporter can be treated by administering a therapeutically effective amount of a serotonin and norepinephrine reuptake inhibitor of the invention.
• Such medical conditions include, by way of example: pain disorders such as neuropathic pain, fibromyalgia, and chronic pain; depressive disorders such as major depression; affective disorders such as an anxiety disorder; attention deficit hyperactivity disorder; cognitive disorders such as dementia; stress urinary incontinence; chronic low back pain; and osteoarthritis.
• the amount of active agent administered per dose or the total amount administered per day may be predetermined or it may be determined on an individual patient basis by taking into consideration numerous factors, including the nature and severity of the patient's condition, the condition being treated, the age, weight, and general health of the patient, the tolerance of the patient to the active agent, the route of administration, pharmacological considerations such as the activity, efficacy, pharmacokinetics and toxicology profiles of the active agent and any secondary agents being administered, and the like.
• Treatment of a patient suffering from a disease or medical condition can begin with a predetermined dosage or a dosage determined by the treating physician, and will continue for a period of time necessary to prevent, ameliorate, suppress, or alleviate the symptoms of the disease or medical condition. Patients undergoing such treatment will typically be monitored on a routine basis to determine the Attorney Docket No. P-268-PCT
• a measure of the effectiveness of treatment may involve assessment of the patient's quality of life, e.g., improvements in the patient's sleeping patterns, work attendance, ability to exercise and be ambulatory, etc. Pain scales, operating on a point basis, may also be used to help evaluate a patient's pain level.
• Indicators for the other diseases and conditions described herein are well-known to those skilled in the art, and are readily available to the treating physician. Continuous monitoring by the physician will insure that the optimal amount of active agent will be administered at any given time, as well as facilitating the determination of the duration of treatment. This is of particular value when secondary agents are also being administered, as their selection, dosage, and duration of therapy may also require adjustment. In this way, the treatment regimen and dosing schedule can be adjusted over the course of therapy so that the lowest amount of active agent that exhibits the desired effectiveness is administered and, further, that administration is continued only so long as is necessary to successfully treat the disease or medical condition.
• SNRIs have been shown to have a beneficial effect on pain such as painful diabetic neuropathy (duloxetine, Goldstein et al. (2005) Pain 116: 109-118; venlafaxine,
• one embodiment of the invention relates to a method for treating a pain disorder, comprising administering to a patient a therapeutically effective amount of a compound of the invention.
• the therapeutically effective amount will be the amount that is sufficient to relieve the pain.
• pain disorders include, by way of illustration, acute pain, persistent pain, chronic pain, inflammatory pain, and neuropathic pain.
• these include pain associated with or caused by: arthritis; back pain including chronic low back pain; cancer, including tumor related pain (e.g., bone pain, headache, facial pain or visceral pain) and pain associated with cancer therapy (e.g., post-chemotherapy syndrome, chronic post-surgical pain syndrome and post- radiation syndrome); carpal tunnel syndrome; fibromyalgia; headaches including chronic tension headaches; inflammation associated with polymyalgia, rheumatoid arthritis and osteoarthritis; migraine; neuropathic pain including complex regional pain syndrome; overall pain; post-operative pain; shoulder pain; central pain syndromes, including post- Attorney Docket No. P-268-PCT
• neuropathic pain which includes diabetic peripheral neuropathy (DPN), HlV-related neuropathy, post-herpetic neuralgia (PHN), and chemotherapy-induced peripheral neuropathy.
• DPN diabetic peripheral neuropathy
• HlV-related neuropathy HlV-related neuropathy
• PPN post-herpetic neuralgia
• chemotherapy-induced peripheral neuropathy e.g., chemotherapy-induced peripheral neuropathy.
• compounds of the invention may be administered in combination with other therapeutic agents, including anticonvulsants, antidepressants, muscle relaxants, NSAIDs, opioid agonists, opioid antagonists, selective serotonin reuptake inhibitors, sodium channel blockers, and sympatholytics. Exemplary compounds within these classes are described herein.
• Another embodiment of the invention relates to a method of treating a depressive disorder, comprising administering to a patient a therapeutically effective amount of a compound of the invention.
• the therapeutically effective amount will be the amount that is sufficient to alleviate depression and provide a sense of general well-being.
• exemplary depressive disorders include, by way of illustration and not limitation:
• compounds of the invention may be administered in combination with other therapeutic agents, including antidepressants and dual serotonin-norepinephrine reuptake inhibitors. Exemplary compounds within these classes are described herein.
• Another embodiment of the invention relates to a method of treating an affective disorder, comprising administering to a patient a therapeutically effective amount of a compound of the invention.
• exemplary affective disorders include, by way of illustration and not limitation: anxiety disorders such as general anxiety disorder; avoidant personality disorder; eating disorders such as anorexia nervosa, bulimia nervosa and obesity; obsessive compulsive disorder; panic disorder; personality disorders such as avoidant personality disorder and attention deficit hyperactivity disorder (ADHD); post-traumatic stress Attorney Docket No. P-268-PCT
• phobias such as agoraphobia, as well as simple and other specific phobias, and social phobia
• premenstrual syndrome psychotic disorders, such as schizophrenia and mania; seasonal affective disorder; sexual dysfunction, including premature ejaculation, male impotence, and female sexual dysfunction such as female sexual arousal disorder; social anxiety disorder; and substance abuse disorders, including chemical dependencies such as addictions to alcohol, benzodiazepines, ***e, heroin, nicotine and phenobarbital, as well as withdrawal syndromes that may arise from these dependencies.
• compounds of the invention may be administered in combination with other therapeutic agents, including antidepressants. Exemplary compounds within these classes are described herein.
• Atomoxetine which is 10-fold NET selective, is approved for attention deficit hyperactivity disorder (ADHD) therapy, and clinical studies have shown that the SNRI, venlafaxine, can also have a beneficial effect in treating ADHD (Mukaddes et al. (2002) Eur. Neuropsychopharm. 12(Supp 3):421).
• ADHD attention deficit hyperactivity disorder
• the compounds of the invention are also expected to be useful in methods for treating attention deficit hyperactivity disorder by administering to a patient a therapeutically effective amount of a compound of the invention.
• compounds of the invention may be any suitable for treating attention deficit hyperactivity disorder (ADHD) therapy, and clinical studies have shown that the SNRI, venlafaxine, can also have a beneficial effect in treating ADHD (Mukaddes et al. (2002) Eur. Neuropsychopharm. 12(Supp 3):421).
• the compounds of the invention are also expected to be useful in methods for treating attention deficit hyperactivity disorder by administering to a patient a therapeutically effective amount of
• a cognitive disorder comprising administering to a patient a therapeutically effective amount of a compound of the invention.
• cognitive disorders include, by way of illustration and not limitation: dementia, which includes degenerative dementia (e.g., Alzheimer's disease, Creutzfeldt- Jakob disease, Huntingdon's chorea, Parkinson's disease, Pick's disease, and senile dementia), vascular dementia (e.g., multi-infarct dementia), and dementia associated with intracranial space occupying lesions, trauma, infections and related conditions (including HIV infection), metabolism, toxins, anoxia and vitamin deficiency; and mild cognitive impairment associated with ageing, such as age associated memory impairment, amnesiac disorder and age-related cognitive decline.
• degenerative dementia e.g., Alzheimer's disease, Creutzfeldt- Jakob disease, Huntingdon's chorea, Parkinson's disease, Pick's disease, and senile dementia
• vascular dementia e.g., multi-infarct dementia
• compounds of the invention When used to treat cognitive disorders, compounds of the invention may be administered in combination with other therapeutic agents, including anti-Alzheimer's agents and anti-Parkinson's agents. Exemplary compounds within these classes are described herein. Attorney Docket No. P-268-PCT
• Another embodiment of the invention relates to a method for treating stress urinary incontinence, comprising administering to a patient a therapeutically effective amount of a compound of the invention.
• compounds of the invention may be administered in combination with other therapeutic agents, including
• Duloxetine an SNRI
• Duloxetine is undergoing clinical trials for evaluating its efficacy in treating chronic fatigue syndrome, and has recently been shown to be effective in treating fibromyalgia (Russell et al. (2008) Pain 136(3):432-444).
• the compounds of the invention due to their ability to inhibit SERT and NET, are also expected to have this utility, and another embodiment of the invention relates to a method for treating chronic fatigue syndrome, comprising administering to a patient a therapeutically effective amount of a compound of the invention.
• Sibutramine a norepinephrine and dopamine reuptake inhibitor
• Sibutramine a norepinephrine and dopamine reuptake inhibitor
• the compounds of the invention due to their ability to inhibit NET, are also expected to have this utility, and another embodiment of the invention relates to a method for treating obesity, comprising administering to a patient a therapeutically effective amount of a compound of the invention.
• Desvenlafaxine an SNRI
• the compounds of the invention due to their ability to inhibit SERT and NET, are also expected to have this utility, and another embodiment of the invention relates to a method for treating vasomotor symptoms associated with menopause, comprising administering to a patient a therapeutically effective amount of a compound of the invention.
• compounds of the invention possess both serotonin reuptake inhibition activity and norepinephrine reuptake inhibition activity, such compounds are also useful as research tools for investigating or studying biological systems or samples having serotonin or norepinephrine transporters. Any suitable biological system or sample having serotonin and/or norepinephrine transporters may be employed in such studies which may be Attorney Docket No. P-268-PCT
• serotonin reuptake in a mammal is inhibited by administering a serotonin reuptake- inhibiting amount of a compound of the invention.
• norepinephrine reuptake in a mammal is inhibited by administering a norepinephrine reuptake-inhibiting amount of a compound of the invention.
• Compounds of the invention can also be used as research tools by conducting biological assays using such compounds.
• a biological system or sample comprising a serotonin transporter and/or a norepinephrine transporter is typically contacted with a serotonin reuptake-inhibiting or norepinephrine reuptake-inhibiting amount of a compound of the invention.
• the effects of inhibiting serotonin reuptake and/or norepinephrine reuptake are determined using conventional procedures and equipment. Exposure encompasses contacting cells or tissue with the compound, administering the compound to a mammal, for example by i.p. or i.v. administration, and so forth.
• This determining step may comprise measuring a response, i.e., a quantitative analysis or may comprise an observation, i.e., a qualitative analysis.
• Measuring a response involves, for example, determining the effects of the compound on the biological system or sample using conventional procedures and equipment, such as serotonin and norepinephrine reuptake assays.
• the assay results can be used to determine the activity level as well as the amount of compound necessary to achieve the desired result, i.e., a serotonin reuptake-inhibiting and a norepinephrine reuptake-inhibiting amount.
• compounds of the invention can be used as research tools for evaluating other chemical compounds, and thus are also useful in screening assays to discover, for example, new compounds having both serotonin reuptake-inhibiting activity and norepinephrine reuptake-inhibiting activity.
• compounds of the invention are used as standards in an assay to allow comparison of the results obtained with a test compound and with compounds of the invention to identify those test compounds that have about equal or superior reuptake-inhibiting activity, if any. For example, reuptake data for a test compound or a group of test compounds is compared to the Attorney Docket No. P-268-PCT
• This aspect of the invention includes, as separate embodiments, both the generation of comparison data (using the appropriate assays) and the analysis of the test data to identify test compounds of interest.
• a test compound can be evaluated in a biological assay, by a method comprising the steps of: (a) conducting a biological assay with a test compound to provide a first assay value; (b) conducting the biological assay with a compound of the invention to provide a second assay value; wherein step (a) is conducted either before, after or concurrently with step (b); and (c) comparing the first assay value from step (a) with the second assay value from step (b).
• Exemplary biological assays include serotonin and norepinephrine reuptake assays.
• Compounds of the invention are typically administered to a patient in the form of a pharmaceutical composition or formulation.
• Such pharmaceutical compositions may be administered to the patient by any acceptable route of administration including, but not limited to, oral, rectal, vaginal, nasal, inhaled, topical (including transdermal) and parenteral modes of administration.
• the compounds of the invention may be administered, for example orally, in multiple doses per day (e.g., twice, three times or four times daily), in a single daily dose, in a twice daily dose, in a single weekly dose, and so forth.
• any form of the compounds of the invention, i.e., free base, pharmaceutically acceptable salt, solvate, etc.
• any form of the compounds of the invention i.e., free base, pharmaceutically acceptable salt, solvate, etc.
• the invention relates to a pharmaceutical composition
• a pharmaceutical composition comprising a pharmaceutically acceptable carrier and a compound of the invention.
• the compositions may contain other therapeutic and/or formulating agents if desired.
• the “compound of the invention” may also be referred to herein as the “active agent,” to distinguish it from other components of the formulation, such as the carrier.
• active agent includes compounds of formula I as well as pharmaceutically acceptable salts and solvates of that compound.
• compositions of the invention typically contain a therapeutically effective amount of a compound of the invention.
• a pharmaceutical composition may contain more than a therapeutically Attorney Docket No. P-268-PCT
• compositions will contain from about 0.01-95 wt% of active agent, including, from about 0.01-30 wt%, such as from about 0.01- 10 wt%, with the actual amount depending upon the formulation itself, the route of administration, the frequency of dosing, and so forth.
• a composition suitable for an oral dosage form may contain about 5-70 wt%, or from about 10-60 wt% of active agent.
• a pharmaceutical composition contains from about 1 to 20 mg of active agent, including from about 1 to 15 mg of active agent and from about 1 to 10 mg of active agent. In another exemplary embodiment, a pharmaceutical composition contains from about 5 to 20 mg of active agent, including from about 7.5 to 15 mg of active agent.
• the active agent may be formulated in 1 mg and 10 mg unit doses.
• any conventional carrier or excipient may be used in the pharmaceutical compositions of the invention.
• the choice of a particular carrier or excipient, or combinations of carriers or excipients, will depend on the mode of administration being used to treat a particular patient or type of medical condition or disease state. In this regard, the preparation of a suitable composition for a particular mode of administration is well within the scope of those skilled in the pharmaceutical arts. Additionally, carriers or excipients used in such compositions are commercially available.
• conventional formulation techniques are described in Remington: The Science and Practice of Pharmacy, 20 th Edition, Lippincott Williams & White, Baltimore, Maryland (2000); and H. C. Ansel et ah, Pharmaceutical Dosage Forms and Drug Delivery Systems, 7 th Edition, Lippincott Williams & White, Baltimore, Maryland (1999).
• materials which can serve as pharmaceutically acceptable carriers include, but are not limited to, the following: sugars, such as lactose, glucose and sucrose; starches, such as corn starch and potato starch; cellulose, such as microcrystalline cellulose, and its derivatives, such as sodium carboxymethyl cellulose, ethyl cellulose and cellulose acetate; powdered tragacanth; malt; gelatin; talc; excipients, such as cocoa butter and suppository waxes; oils, such as peanut oil, cottonseed oil, safflower oil, sesame oil, olive oil, corn oil and soybean oil; glycols, such as propylene glycol; polyols, such as glycerin, sorbitol, mannitol and polyethylene glycol; esters, such as ethyl oleate and ethyl laurate; agar; buffering agents, such as magnesium hydroxide and Attorney Docket No. P-268-PCT
• compositions are typically prepared by thoroughly and intimately mixing or blending the active agent with a pharmaceutically acceptable carrier and one or more optional ingredients.
• the resulting uniformly blended mixture may then be shaped or loaded into tablets, capsules, pills, canisters, cartridges, dispensers, and the like, using conventional procedures and equipment.
• the pharmaceutical compositions are suitable for oral administration.
• One exemplary dosing regimen would be an oral dosage form
• compositions for oral administration may be in the form of capsules, tablets, pills, lozenges, cachets, dragees, powders, granules; solutions or suspensions in an aqueous or non-aqueous liquid; oil-in-water or water-in-oil liquid emulsions; elixirs or syrups; and the like; each containing a predetermined amount of the active agent.
• the composition When intended for oral administration in a solid dosage form (i.e., as capsules, tablets, pills, and the like), the composition will typically comprise the active agent and one or more pharmaceutically acceptable carriers, such as sodium citrate or dicalcium phosphate.
• Solid dosage forms may also comprise: fillers or extenders, such as starches, microcrystalline cellulose, lactose, sucrose, glucose, mannitol, and/or silicic acid; binders, such as carboxymethylcellulose, alginates, gelatin, polyvinyl pyrrolidone, sucrose and/or acacia; humectants, such as glycerol; disintegrating agents, such as agar-agar, calcium carbonate, potato or tapioca starch, alginic acid, certain silicates, and/or sodium carbonate; solution retarding agents, such as paraffin; absorption accelerators, such as quaternary ammonium compounds; wetting agents, such as cetyl alcohol and/or glycerol
• Release agents, wetting agents, coating agents, sweetening, flavoring and perfuming agents, preservatives and antioxidants may also be present in the pharmaceutical compositions.
• Exemplary coating agents for tablets, capsules, pills and like include those used for enteric coatings, such as cellulose acetate phthalate, polyvinyl acetate phthalate, Attorney Docket No. P-268-PCT
• hydroxypropyl methylcellulose phthalate methacrylic acid-methacrylic acid ester copolymers, cellulose acetate trimellitate, carboxymethyl ethyl cellulose, hydroxypropyl methyl cellulose acetate succinate, and the like.
• antioxidants examples include: water-soluble antioxidants, such as ascorbic acid, cysteine hydrochloride, sodium bisulfate, sodium metabisulfate, sodium sulfite, and the like; oil- soluble antioxidants, such as ascorbyl palmitate, butylated hydroxyanisole, butylated hydroxytoluene, lecithin, propyl gallate, alpha-tocopherol, and the like; and metal- chelating agents, such as citric acid, ethylenediamine tetraacetic acid, sorbitol, tartaric acid, phosphoric acid, and the like.
• water-soluble antioxidants such as ascorbic acid, cysteine hydrochloride, sodium bisulfate, sodium metabisulfate, sodium sulfite, and the like
• oil- soluble antioxidants such as ascorbyl palmitate, butylated hydroxyanisole, butylated hydroxytoluene, lecithin, propyl gallate, alpha-
• compositions may also be formulated to provide slow or controlled release of the active agent using, by way of example, hydroxypropyl methyl cellulose in varying proportions or other polymer matrices, liposomes and/or microspheres.
• the pharmaceutical compositions of the invention may contain opacifying agents and may be formulated so that they release the active agent only, or preferentially, in a certain portion of the gastrointestinal tract, optionally, in a delayed manner. Examples of embedding compositions which can be used include polymeric substances and waxes.
• the active agent can also be in micro-encapsulated form, if appropriate, with one or more of the above-described excipients.
• Suitable liquid dosage forms for oral administration include, by way of illustration, pharmaceutically acceptable emulsions, microemulsions, solutions, suspensions, syrups and elixirs.
• Liquid dosage forms typically comprise the active agent and an inert diluent, such as, for example, water or other solvents, solubilizing agents and emulsifiers, such as ethyl alcohol, isopropyl alcohol, ethyl carbonate, ethyl acetate, benzyl alcohol, benzyl benzoate, propylene glycol, 1,3-butylene glycol, oils (e.g., cottonseed, groundnut, corn, germ, olive, castor and sesame oils), glycerol, tetrahydrofuryl alcohol, polyethylene glycols and fatty acid esters of sorbitan, and mixtures thereof.
• inert diluent such as, for example, water or other solvents, solubilizing agents and emulsifier
• Suspensions may contain suspending agents such as, for example, ethoxylated isostearyl alcohols, polyoxyethylene sorbitol and sorbitan esters, microcrystalline cellulose, aluminium metahydroxide, bentonite, agar-agar and tragacanth, and mixtures thereof.
• suspending agents such as, for example, ethoxylated isostearyl alcohols, polyoxyethylene sorbitol and sorbitan esters, microcrystalline cellulose, aluminium metahydroxide, bentonite, agar-agar and tragacanth, and mixtures thereof.
• the pharmaceutical compositions of the invention may be packaged in a unit dosage form.
• unit dosage form refers to a physically discrete unit suitable for dosing a patient, i.e., each unit containing a predetermined quantity of the active agent calculated to produce the desired therapeutic Attorney Docket No. P-268-PCT
• unit dosage forms may be capsules, tablets, pills, and the like.
• compositions of the invention are suitable for inhaled administration, and will typically be in the form of an aerosol or a powder.
• Such compositions are generally administered using well-known delivery devices, such as a nebulizer, dry powder, or metered-dose inhaler.
• Nebulizer devices produce a stream of high velocity air that causes the composition to spray as a mist that is carried into a patient's respiratory tract.
• An exemplary nebulizer formulation comprises the active agent dissolved in a carrier to form a solution, or micronized and combined with a carrier to form a suspension of micronized particles of respirable size.
• Dry powder inhalers administer the active agent as a free- flowing powder that is dispersed in a patient's air-stream during inspiration.
• An exemplary dry powder formulation comprises the active agent dry-blended with an excipient such as lactose, starch, mannitol, dextrose, polylactic acid, polylactide- co-glycolide, and combinations thereof.
• Metered-dose inhalers discharge a measured amount of the active agent using compressed propellant gas.
• An exemplary metered-dose formulation comprises a solution or suspension of the active agent in a liquefied propellant, such as a chlorofluorocarbon or hydrofluoroalkane.
• Optional components of such formulations include co-solvents, such as ethanol or pentane, and surfactants, such as sorbitan trioleate, oleic acid, lecithin, and glycerin.
• compositions are typically prepared by adding chilled or pressurized hydrofluoroalkane to a suitable container containing the active agent, ethanol (if present) and the surfactant (if present). To prepare a suspension, the active agent is micronized and then combined with the propellant.
• a suspension formulation can be prepared by spray drying a coating of surfactant on micronized particles of the active agent. The formulation is then loaded into an aerosol canister, which forms a portion of the inhaler.
• Compounds of the invention can also be administered parenterally (e.g., by subcutaneous, intravenous, intramuscular, or intraperitoneal injection).
• the active agent is provided in a sterile solution, suspension, or emulsion.
• Exemplary solvents for preparing such formulations include water, saline, low molecular weight alcohols such as propylene glycol, polyethylene glycol, oils, gelatin, fatty acid esters such as ethyl oleate, and the like.
• a typical parenteral formulation is a sterile pH 4-7 aqueous solution of the active agent.
• Parenteral formulations may also contain one or more solubilizers, stabilizers, preservatives, wetting agents, emulsifiers, and dispersing agents.
• Attorney Docket No. P-268-PCT Attorney Docket No. P-268-PCT
• formulations may be rendered sterile by use of a sterile injectable medium, a sterilizing agent, filtration, irradiation, or heat.
• Compounds of the invention can also be administered transdermally using known transdermal delivery systems and excipients.
• the compound can be admixed with permeation enhancers, such as propylene glycol, polyethylene glycol monolaurate, azacycloalkan-2-ones, and the like, and incorporated into a patch or similar delivery system.
• permeation enhancers such as propylene glycol, polyethylene glycol monolaurate, azacycloalkan-2-ones, and the like.
• Additional excipients including gelling agents, emulsifiers and buffers, may be used in such transdermal compositions if desired.
• compositions of the invention may optionally contain other drugs that are co-administered with a compound of the invention.
• the composition may further comprise one or more drugs (also referred to as "secondary agents(s)") selected from the group of anti-Alzheimer's agents, anticonvulsants (antiepileptics), antidepressants, anti-Parkinson's agents, dual serotonin- norepinephrine reuptake inhibitors (SNRIs), non-steroidal anti-inflammatory agents
• a pharmaceutical composition comprises a compound of the invention, a second active agent, and a pharmaceutically acceptable carrier.
• active agents may also be included in the composition.
• the amount of compound of the invention that is administered, as well as the amount of secondary agents may be less than the amount typically administered in monotherapy.
• a compound of the invention may be either physically mixed with the second active agent to form a composition containing both agents; or each agent may be present in Attorney Docket No. P-268-PCT
• compositions which are administered to the patient simultaneously or sequentially.
• a compound of the invention can be combined with a second active agent using conventional procedures and equipment to form a combination of active agents comprising a compound of the invention and a second active agent.
• the active agents may be combined with a pharmaceutically acceptable carrier to form a pharmaceutical composition comprising a compound of the invention, a second active agent and a pharmaceutically acceptable carrier.
• the components of the composition are typically mixed or blended to create a physical mixture. The physical mixture is then administered in a therapeutically effective amount using any of the routes described herein.
• the active agents may remain separate and distinct before administration to the patient.
• the agents are not physically mixed together before administration but are administered simultaneously or at separate times as separate compositions.
• Such compositions can be packaged separately or may be packaged together in a kit.
• the secondary agent will typically be administered less than 24 hours after administration of the compound of the invention, ranging anywhere from concurrent with administration of the compound of the invention to about 24 hours post-dose. This is also referred to as sequential administration.
• a compound of the invention can be orally administered simultaneously or sequentially with another active agent using two tablets, with one tablet for each active agent, where sequential may mean being administered immediately after administration of the compound of the invention or at some predetermined time later (e.g., one hour later or three hours later).
• the combination may be administered by different routes of administration, i.e., one orally and the other by inhalation.
• the kit comprises a first dosage form comprising a compound of the invention and at least one additional dosage form comprising one or more of the secondary agents set forth herein, in quantities sufficient to carry out the methods of the invention.
• the first dosage form and the second (or third, etc.) dosage form together comprise a therapeutically effective amount of active agents for the treatment or prevention of a disease or medical condition in a patient.
• Secondary agent(s), when included, are present in a therapeutically effective amount, i.e., are typically administered in an amount that produces a therapeutically beneficial effect when co-administered with a compound of the invention.
• the secondary Attorney Docket No. P-268-PCT The secondary Attorney Docket No. P-268-PCT
• agent can be in the form of a pharmaceutically acceptable salt, solvate, optically pure stereoisomer, and so forth.
• secondary agents listed below are intended to include all such forms, and are commercially available or can be prepared using conventional procedures and reagents.
• anti-Alzheimer's agents include, but are not limited to: donepezil, galantamine, memantine, rivastigmine, selegiline, tacrine, and combinations thereof.
• anticonvulsants include, but are not limited to: acetazolamide, albutoin, 4-amino-3-hydroxybutyric acid, beclamide, carbamazepine, cinromide, clomethiazole, clonazepam, diazepam, dimethadione, eterobarb, ethadione, ethosuximide, ethotoin, felbamate, fosphenytoin, gabapentin, lacosamide, lamotrigine, lorazepam, magnesium bromide, magnesium sulfate, mephenytoin, mephobarbital, methsuximide, midazolam, nitrazepam, oxazepam, oxcarbazepine, paramethadione, phenacemide, pheneturide, phenobarbital, phensuximide, phenytoin, potassium bromide
• antidepressants include, but are not limited to: adinazolam, amitriptyline, clomipramine, desipramine, dothiepin (e.g., dothiepin hydrochloride), doxepin, imipramine, lofepramine, mirtazapine, nortriptyline, protriptyline, trimipramine, venlafaxine, zimelidine, and combinations thereof.
• Representative anti-Parkinson's agents include, but are not limited to: amantadine, apomorphine, benztropine, bromocriptine, carbidopa, diphenhydramine, entacapone, levodopa, pergolide, pramipexole, ropinirole, selegiline, tolcapone, trihexyphenidyl, and combinations thereof.
• Representative dual serotonin-norepinephrine reuptake inhibitors include, but are not limited to: bicifadine, desvenlafaxine, duloxetine, milnacipran, nefazodone, venlafaxine, and combinations thereof.
• NSAIDs non-steroidal anti-inflammatory agents
• Representative non-steroidal anti-inflammatory agents include, but are not limited to: acemetacin, acetaminophen, acetyl salicylic acid, alclofenac, alminoprofen, amfenac, amiprilose, amoxiprin, anirolac, apazone, azapropazone, benorilate,
• fenoprofen fentiazac, feprazone, flufenamic acid, flufenisal, fluprofen, flurbiprofen, furofenac, ibufenac, ibuprofen, indomethacin, indoprofen, isoxepac, isoxicam, ketoprofen, ketorolac, lofemizole, lornoxicam, meclofenamate, meclofenamic acid, mefenamic acid, meloxicam, mesalamine, miroprofen, mofebutazone, nabumetone, naproxen, niflumic acid, nimesulide, nitroflurbiprofen, olsalazine, oxaprozin, oxpinac, oxyphenbutazone, phenylbutazone, piroxicam, pirprofen, pranoprofen, salsalate, sudoxicam,
• the NSAID is selected from etodolac, flurbiprofen, ibuprofen, indomethacin, ketoprofen, ketorolac, meloxicam, naproxen, oxaprozin, piroxicam, and combinations thereof.
• the NSAID is selected from ibuprofen, indomethacin, nabumetone, naproxen (for example, naproxen sodium), and combinations thereof.
• Representative muscle relaxants include, but are not limited to: carisoprodol, chlorzoxazone, cyclobenzaprine, diflunisal, metaxalone, methocarbamol, and combinations thereof.
• norepinephrine reuptake inhibitors include, but are not limited to: atomoxetine, buproprion and the buproprion metabolite hydroxybuproprion, maprotiline, reboxetine (for example, (S. ⁇ j-reboxetine), viloxazine, and combinations thereof.
• the norepinephrine reuptake inhibitor is selected from atomoxetine, reboxetine, and combinations thereof.
• opioid agonists opioid analgesics
• antagonists include, but are not limited to: buprenorphine, butorphanol, codeine, dihydrocodeine, fentanyl,
• the opioid agonist is selected from codeine,
• dihydrocodeine hydrocodone, hydromorphone, morphine, oxycodone, oxymorphone, tramadol, and combinations thereof.
• SSRIs selective serotonin reuptake inhibitors
• Representative selective serotonin reuptake inhibitors include, but are not limited to: citalopram and the citalopram metabolite desmethylcitalopram, dapoxetine, escitalopram (e.g., escitalopram oxalate), fluoxetine and the fluoxetine desmethyl metabolite norfluoxetine, fluvoxamine (e.g., fluvoxamine maleate), paroxetine, sertraline and the sertraline metabolite demethylsertraline, and combinations thereof.
• citalopram and the citalopram metabolite desmethylcitalopram dapoxetine
• escitalopram e.g., escitalopram oxalate
• fluoxetine desmethyl metabolite norfluoxetine
• fluvoxamine e.g., fluvoxamine maleate
• paroxetine sertraline
• the SSRI is selected from citalopram, paroxetine, sertraline, and
• Representative sodium channel blockers include, but are not limited to:
• carbamazepine fosphenytoin, lamotrignine, lidocaine, mexiletine, oxcarbazepine, phenytoin, and combinations thereof.
• Thallolytics include, but are not limited to: atenolol, clonidine, doxazosin, guanethidine, guanfacine, modafinil, phentolamine, prazosin, reserpine, tolazoline (e.g., tolazoline hydrochloride), tamsulosin, and combinations thereof.
• Exemplary Hard Gelatin Capsules For Oral Administration A compound of the invention (50 g), spray-dried lactose (440 g) and magnesium stearate (10 g) are thoroughly blended. The resulting composition is then loaded into hard gelatin capsules (500 mg of composition per capsule).
• Exemplary Gelatin Capsule Formulation For Oral Administration A compound of the invention (100 mg) is thoroughly blended with poly oxy ethylene sorbitan monooleate (50 mg) and starch powder (250 mg). The mixture is then loaded into a gelatin capsule (400 mg of composition per capsule).
• a compound of the invention (40 mg) is thoroughly blended with microcrystalline cellulose (Avicel PH 103; 259.2 mg) and magnesium stearate (0.8 mg). The mixture is then loaded into a gelatin capsule (Size #1, White, Opaque) (300 mg of composition per capsule).
• a compound of the invention (10 mg), starch (45 mg) and microcrystalline cellulose (35 mg) are passed through a No. 20 mesh U.S. sieve and mixed thoroughly.
• the granules so produced are dried at 50-60°C and passed through a No. 16 mesh U.S. sieve.
• a solution of polyvinylpyrrolidone (4 mg as a 10 % solution in sterile water) is mixed with sodium carboxymethyl starch (4.5 mg), magnesium stearate (0.5 mg), and talc (1 mg), and this mixture is then passed through a No. 16 mesh U.S. sieve.
• the sodium carboxymethyl Attorney Docket No. P-268-PCT
• a compound of the invention 250 mg is thoroughly blended with microcrystalline cellulose (400 mg), silicon dioxide fumed (10 mg), and stearic acid (5 mg). The mixture is then compressed to form tablets (665 mg of composition per tablet).
• a compound of the invention 400 mg is thoroughly blended with cornstarch (50 mg), croscarmellose sodium (25 mg), lactose (120 mg), and magnesium stearate (5 mg). The mixture is then compressed to form a single-scored tablet (600 mg of compositions per tablet).
• Veegum ® K magnesium aluminum silicate
• Exemplary Injectable Formulation For Administration By Injection A compound of the invention (0.2 g) is blended with 0.4 M sodium acetate buffer solution (2.0 mL). The pH of the resulting solution is adjusted to pH 4 using 0.5 N aqueous hydrochloric acid or 0.5 N aqueous sodium hydroxide, as necessary, and then sufficient water for injection is added to provide a total volume of 20 mL. The mixture is then filtered through a sterile filter (0.22 micron) to provide a sterile solution suitable for administration by injection.
• compositions for Administration By Inhalation A compound of the invention (0.2 mg) is micronized and then blended with lactose (25 mg). This blended mixture is then loaded into a gelatin inhalation cartridge. The contents of the cartridge are administered using a dry powder inhaler, for example.
• a micronized compound of the invention (10 g) is dispersed in a Attorney Docket No. P-268-PCT
• micronized composition comprising particles having a mean diameter less than about 1.5 ⁇ .
• the micronized composition is then loaded into metered-dose inhaler cartridges containing pressurized 1, 1, 1,2-tetrafluoroethane in an amount sufficient to provide about 10 ⁇ g to about 500 ⁇ g of the compound of the invention per dose when administered by the inhaler.
• a compound of the invention 25 mg is dissolved in citrate buffered (pH 5) isotonic saline (125 mL). The mixture is stirred and sonicated until the compound is dissolved. The pH of the solution is checked and adjusted, if necessary, to pH 5 by slowly adding aqueous IN sodium hydroxide. The solution is administered using a nebulizer device that provides about 10 ⁇ g to about 500 ⁇ g of the compound of the invention per dose.
• Triethylamine (280 mL, 2.0 mol, 2.5 eq.) was added, in several batches, to a solution of phenylamine (75.0 g, 805.3 mmol, 1.0 eq.) in DCM (550 mL) under nitrogen. This solution was cooled to -78°C then trifluoromethanesulfonic anhydride (270 mL, 1.6 mol, 2.0 eq.) was added. The resulting solution was stirred for 2 hours while the temperature was maintained at -78°C in an EtOH/liquid 2 bath. The resulting solution was stirred while the temperature was allowed to increase to room temperature. The mixture was stirred overnight at room temperature, then washed with 10% HC1
• DPPF (6.0 g, 10.8 mmol, 0.05 eq.) was added to a solution of 4,4,5,5,4',4',5',5'- cctamethyl-[2,2']bi[[l,3,2]dioxaborolanyl] (72.8 g, 286.7 mmol, 1.2 eq.) in 1,4-dioxane (1000 mL), under nitrogen.
• PdCl 2 /DPPF/CHCl 3 (6.7 g, 7.9 mmol, 0.03 eq.) was then added, followed by the addition of potassium acetate (76.0 g, 774.4 mmol, 3.3 eq.).
• PPI1 3 (28.9 mg, 0.1 mmol, 1.1 eq.) and 2-hydroxymethyl-3',4',5',6'-tetrahydro-2'H- [3,4']bipyridinyl-l'-carboxylic acid ?-butyl ester (29.2 mg, 0.1 mmol, 1.0 eq.) were dissolved in toluene (533 ⁇ ). 2,4,6-Trifluorophenol (14.8 mg, 0.1 mmol, 1.0 eq.) was added, followed by the addition of DIAD (23.6 ⁇ , 0.1 mmol, 1.2 eq.) in toluene (5 mL).
• the resulting solution was stirred for 1 hour at approximately -60 to -50°C.
• the resulting solution was added dropwise to a solution of 4-bromopyridine hydrochloride (20.0 g, 102.9 mmol, 1.0 eq.) in THF (100 mL) at -78°C.
• the resulting solution was stirred for 2 hours.
• Carbon dioxide gas was introduced into the reaction vessel for 30 minutes.
• the resulting solution was stirred overnight at room temperature.
• the reaction was then quenched with water (100 mL).
• the resulting solution was extracted with EtOAc
• Ci 7 H 18 F 2 N 2 0, 305.14; found 305.2.
• PdCl 2 (PPh 3 ) 2 (0.7 g, 1.03 mmol, 0.05 eq.) was added to a solution of 4-(4,4,5,5- tetramethyl-[l,3,2]dioxaborolan-2-yl)-3,6-dihydro-2H-pyridine-l-carboxylic acid ?-butyl ester (6.3 g, 20.5 mmol, 1.0 eq.) in THF (120 mL) under nitrogen. To this was added 3- bromoisonicotinic acid methyl ester (4.4 g, 20.5 mmol, 1.0 eq.).
• Pd(OH) 2 /C (0.4 g) was added to a solution of 3',6'-dihydro-2'H-[3,4']bipyridinyl- 4, l'-dicarboxylic acid ⁇ - ⁇ -butyl ester 4-methyl ester (500 mg, 1.2 mmol, 1.0 eq.) in EtOAc (15 mL), maintained under hydrogen at 1 atm. The resulting solution was stirred over night at room temperature. The solids were filtered. The resulting mixture was concentrated under vacuum.
• butyl ester 4-methyl ester (3.3 g, 8.2 mmol, 1.0 eq.) in THF (50mL) was added dropwise to a solution of LiAlH 4 (590 mg, 15.5 mmol, 1.5 eq.) in THF (50 mL) at 0°C under nitrogen. The resulting solution was stirred for 10 minutes at 0°C. The reaction was then quenched with water (0.6 mL) and 15%NaOH (1.8mL). The solids were filtered. The mixture was dried over anhydrous Na 2 S0 4 and concentrated under vacuum. The residue was applied onto a silica gel column and eluted with EtOAc/PE (1: 1) to yield the title compound (1.8 g) as a white solid. MS m/z: [M+H] + calcd for C16H25 2O3, 293; found 293.
• 2-bromonicotinic acid methyl ester (7.1 g, 33.0 mmol, 1.0 eq.) was combined with a solution of 4-(4,4,5,5-tetramethyl-[l,3,2]dioxaborolan-2-yl)-3,6-dihydro-2H-pyridine-l- carboxylic acid ?-butyl ester (10.2 g, 33.0 mmol, 1.0 eq.) in THF (330 mL), under nitrogen. A solution of a 2 C0 3 (14 g) in water (66 mL) was then added, followed by the addition of PdCi 2 (PPh 3 ) 2 (1.2 g, 1.7 mmol, 0.05 eq.).
• PdCl 2 (PPh 3 ) 2 (0.3 g, 0.4 mmol, 0.03 eq.) was added, and the mixture was again degassed and purged with nitrogen (3x), then heated at 80°C overnight. The mixture was then cooled and the layers were separated. The THF layer was diluted with EtOAc (150 mL), washed with saturated aqueous NaCl (80 mL) and dried over Na 2 S0 4 .
• i-butyl ester (4.2 g, 14.0 mmol, 1.0 eq.), THF (150 mL) and Na 2 C0 3 (28 mL, 56 mmol, 4.0 eq.) were combined. The mixture was degassed and purged with nitrogen (3x).
• PdCi 2 (PPh 3 ) 2 (0.3 g, 0.4 mmol, 0.03 eq.) was added, and the mixture was again degassed and purged with nitrogen (3x), then heated at 80°C overnight. The mixture was then cooled and the layers were separated. The THF layer was diluted with EtOAc (150 mL), washed with saturated aqueous NaCl (50 mL) and dried over Na 2 S0 4 .
• PPI1 3 28.9 mg, 0.1 mmol, 1.1 eq.
• 4-(3-Hydroxymethyl-thiophen-2- yl)piperidine-l-carboxylic acid ?-butyl ester 29.7 mg, 0.1 mmol; 1.0 eq.
• Phenol 9.4 mg, 0.1 mmol, 1.0 eq.
• DIAD 23.6 ⁇ , 0.1 mmol, 1.2 eq.
• Membrane radioligand binding assays were used to measure inhibition of labeled ligand ( 3 H-citalopram or 3 H-nisoxetine or 3 H-WIN35428) binding to membranes prepared from cells expressing the respective human recombinant transporter (hSERT or hNET or hDAT) in order to determine the p3 ⁇ 4 values of test compounds at the transporters.
• HEK-293 Human embryonic kidney derived cell lines stably transfected with hSERT or hNET, respectively, were grown in DMEM medium supplemented with 10% dialyzed FBS (for hSERT) or FBS (for hNET), 100 ⁇ g/ml penicillin, 100 ⁇ g/ml streptomycin, 2 mM L-glutamine and 250 ⁇ g/ml of the
• Binding assays were performed in a 96-well assay plate in a total volume of 200 ⁇ , assay buffer (50mM Tris-HCl, 120mM NaCl, 5mM KC1, pH 7.4) with 0.5, 1, and 3 ⁇ g membrane protein, for SERT, NET and DAT, respectively.
• Saturation binding studies, to determine radioligand 3 ⁇ 4 values for 3 H-citalopram, 3 H-nisoxetine, or 3 H- WIN35428, respectively were conducted using 12 different radioligand concentrations ranging from 0.005-10 nM ( 3 H-citalopram); 0.01-20 nM ( 3 H-nisoxetine) and 0.2-50 nM ( 3 H-WIN35428).
• test compound Stock solutions (10 mM in DMSO) of test compound were prepared and serial dilutions made using Dilution Buffer (50 mM Tris-HCl, 120 mM NaCl, 5mM KC1, pH 7.4, 0.1% BSA, 400 ⁇ ascorbic acid).
• Dilution Buffer 50 mM Tris-HCl, 120 mM NaCl, 5mM KC1, pH 7.4, 0.1% BSA, 400 ⁇ ascorbic acid.
• Non-specific radioligand binding was determined in the presence of 1 ⁇ duloxetine, 1 ⁇ desipramine or 10 ⁇ GBR12909 (each in Dilution Buffer) for the hSERT, hNET or hDAT assays, respectively.
• the membranes were harvested by rapid filtration over a 96-well UniFilter GF/B plate, pretreated with 0.3% polyethyleneimine, and washed 6 times with 300 ⁇ wash buffer (50 mM Tris-HCl, 0.9% NaCl, pH 7.5 at 4°C). Plates were dried overnight at room temperature, ⁇ 45 ⁇ of MicroScintTM-20 (Perkin Elmer) added and bound radioactivity quantitated via liquid scintillation spectroscopy. Inhibition curves and saturation isotherms were analyzed using GraphPad Prism Software package (GraphPad Software, Inc., San Diego, CA).
• IC5 0 values were generated from concentration response curves using the Sigmoidal Dose Response (variable slope) algorithm in Prism GraphPad.
• Ka and B max values for the radioligand were generated from saturation isotherms using the Saturation Binding Global Fit algorithm in Prism GraphPad.
• hSERT, hNET, and hDAT Neurotransmitter Uptake Assays were used to measure inhibition of 3 H-serotonin ( 3 H-5-HT), 3 H-norepinephrine ( 3 H-NE), and 3 H-dopamine ( 3 H-DA) uptake into cells expressing the respective transporter (hSERT, hNET or hDAT) in order to determine the PIC5 0 values of test compounds at the transporters.
• 3 H-5-HT 3 H-NE, and 3 H-DA Uptake Assays HEK-293 derived cell lines stably-transfected with hSERT, hNET, or hDAT, respectively, were grown in DMEM medium supplemented with 10% dialyzed FBS (for hSERT) or FBS (for hNET and hDAT), 100 ⁇ g/ml penicillin, 100 ⁇ g/ml streptomycin, 2 mM L-glutamine and 250 ⁇ g/ml of the aminoglycoside antibiotic G418 (for hSERT and hNET) or 800ug/ml (for hDAT), in a 5% C0 2 humidified incubator at 37°C.
• FBS for hSERT
• FBS for hNET and hDAT
• concentration of cells in the cell suspension was 7.5 x 10 4 cells/ml, 1.25 xlO 5 cells/ml, and 5.0 x 10 4 cells/ml for SERT, NET, and DAT cell lines, respectively.
• Neurotransmitter uptake assays were performed in a 96-well assay plate in a total volume of 400 ⁇ ⁇ assay buffer (Krebs-Ringer bicarbonate buffer containing HEPES (10 mM), CaCl 2 (2.2 mM), ascorbic acid (200 ⁇ ) and pargyline (200 ⁇ ), pH 7.4) with 1.5 x 10 4 and 2.5 x 10 4 cells, for SERT and NET, respectively.
• Inhibition assays for determination of pICso values of test compounds were conducted with 11 different concentrations, ranging from 10 pM to 100 ⁇ .
• test compound Stock solutions (10 mM in DMSO) of test compound were prepared and serial dilutions prepared using 50 mM Tris-HCl, 120 mM NaCl, 5mM KC1, pH 7.4, 0.1% BSA, 400 ⁇ ascorbic acid. Test compounds were incubated for 30 minutes at 37°C with the respective cells, prior to addition of radiolabeled neurotransmitter, 3 H-5-HT (20 nM final concentration), 3 H-NE (50 nM final
• Non-specific neurotransmitter uptake was determined in the presence of 2.5 ⁇ duloxetine or 2.5 ⁇ desipramine (each in Dilution Buffer) for the hSERT, hNET, or hDAT assays, respectively.
• Radioligand association assays are performed in a 96-well assay plate in a total volume of 200 ⁇ assay buffer (50mM Tris-HCl, 120mM NaCl, 5mM KCl, 0.025% BSA, pH 7.4) with 650 ⁇ g wet weight tissue (equivalent to 25 ⁇ g protein). Homogenates are incubated for up to 5 minutes with 3 H-citalopram (3 nM) and 3 H-nisoxetine (5 nM), respectively, prior to termination of the assay by rapid filtration over a 96-well UniFilter GF/B plate, pretreated with 0.3% polyethyleneimine.
• assay buffer 50mM Tris-HCl, 120mM NaCl, 5mM KCl, 0.025% BSA, pH 7.4
• Homogenates are incubated for up to 5 minutes with 3 H-citalopram (3 nM) and 3 H-nisoxetine (5 nM), respectively, prior to termination of the assay by
• nisoxetine are determined by linear regression using GraphPad Prism Software package (GraphPad Software, Inc., San Diego, CA). The average rate of radioligand association to brain tissue homogenates from vehicle-treated animals is determined. The % occupancy of test compounds is then determined using the following equation:
• % occupancy 100 x (1 - (initial rate association for test compound-treated tissue/ mean rate association for vehicle-treated tissue))
• ED 50 values are determined by plotting the log 10 of the dose of the test compound against the % occupancy.
• ED 50 values are generated from concentration response curves using the Sigmoidal Dose Response (variable slope) algorithm in GraphPad Prism.
• Ex vivo neurotransmitter uptake assays in which the uptake of 3 H-5-HT or 3 H-NE into rat brain crude homogenates, prepared from vehicle and test compound-treated animals, are used to measure in vivo SERT and NET transporter occupancy (see Wong et al. (1993) Neuropsychopharmacology 8(l):23-33).
• Crude brain tissue homogenates are prepared by homogenizing frozen tissue pieces in 0.5 mL (per mg wet weight) of 10 mM HEPES buffer pH 7.4, containing 0.32 M sucrose, 200 ⁇ ascorbic acid and 200 ⁇ pargyline, at 22°C.
• Neurotransmitter uptake assays are performed in a 96-well Axygen plate in a total volume of 350 ⁇ assay buffer (Krebs-Ringer bicarbonate buffer with 10 mM HEPES, 2.2 mM CaCl 2 , 200 ⁇ ascorbic acid and 200 ⁇ pargyline, pH 7.4) with 50 ⁇ g protein. Homogenates are incubated for 5 minutes at 37°C with 3 H-5-HT (20 nM) and 3 H-NE (50 nM), respectively, prior to termination of the assay by rapid filtration over a 96-well UniFilter GF/B plate, pretreated with 1% BSA.
• assay buffer Karls-Ringer bicarbonate buffer with 10 mM HEPES, 2.2 mM CaCl 2 , 200 ⁇ ascorbic acid and 200 ⁇ pargyline, pH 7.4
• Homogenates are incubated for 5 minutes at 37°C with 3 H-5-HT (20 nM) and 3 H-NE
• test compounds include, but are not limited to, cold ligand binding kinetics assays (Motulsky and Mahan (1984) Molecular Pharmacol. 25(1): 1-9) with membranes prepared from cells expressing hSERT or hNET; conventional membrane radioligand binding assays using Attorney Docket No. P-268-PCT
• radiolabeled, for example, tritiated, test compound radiolabeled, for example, tritiated, test compound
• radioligand binding assays using native tissue from, for example rodent or human brain radioligand binding assays using native tissue from, for example rodent or human brain
• neurotransmitter uptake assays using human or rodent platelets neurotransmitter uptake assays using crude, or pure, synaptosome preparations from rodent brain.
• Compounds are assessed for their ability to inhibit the behavioral response evoked by a 50 ⁇ injection of formalin (5%).
• a metal band is affixed to the left hind paw of male Sprague-Dawley rats (200-250 g) and each rat is conditioned to the band for 60 minutes within a plastic cylinder (15 cm diameter).
• Compounds are prepared in pharmaceutically acceptable vehicles and administered systemically (i.p., p.o.) at pre-designated times before formalin challenge.
• Spontaneous nociceptive behaviors consisting of flinching of the injected (banded) hind paw are counted continuously for 60 minutes using an automated nociception analyzer (UCSD Anesthesiology Research, San Diego, CA).
• Antinociceptive properties of test articles are determined by comparing the number of flinches in the vehicle and compound-treated rats (Yaksh et al. , "An automated flinch detecting system for use in the formalin nociceptive bioassay” (2001) J. Appl. Physiol. 90(6):2386-2402).
• the degree of nerve injury-induced mechanical sensitivity before and after treatment serves as an index of the compounds' antinociceptive properties.

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